Liver Steatosis Is Common in Hepatitis C Patients, Especially Those with Genotype 3

In the February 2008 Journal of Viral Hepatitis, an international research team reported on a study of steatosis in 207 chronic hepatitis C patients treated with pegylated interferon alfa-2a (PegIntron) plus ribavirin.

Results

• 45 of 207 patients (22%) had steatosis in > 5% of liver cells at baseline.

• Significantly more subjects with steatosis had HCV genotype 3 compared to those without steatosis (51% vs 14%; P < 0.0001).

• Patients with steatosis also had:

• Higher HCV RNA level (P = 0.0045);

• Greater body weight (P = 0.0176);

• Higher body mass index (BMI) (P = 0.0352);

• Higher serum triglyceride level (P = 0.0364);

• Greater incidence of hypertriglyceridemia (P = 0.0009);

• Greater likelihood of current or past high blood pressure (P = 0.0229);

• Lower cholesterol level (P = 0.0009).

• Significant predictors of steatosis overall were:

• Genotype 3 HCV (OR 9.04; P < 0.0001);

• Higher HCV RNA (OR 2.96; P = 0.0019);

• Higher triglycerides (OR 1.06; P = 0.0071).

• Among genotype 3 patients, however, HCV RNA was the only significant predictor of steatosis (OR 11.15; P = 0.0012).

• Among patients with other HCV genotypes, hypertriglyceridemia was the only significant predictor of steatosis (OR 1.07; P = 0.0041).

• 134 of 207 patients (65%) achieved sustained virological response (SVR) with pegylated interferon plus ribavirin.

• Among genotype 3 patients with SVR, steatosis decreased from 48% to 13%.

• No change was observed in steatosis among non-genotype 3 patients with SVR.

Conclusion

In conclusion, the study authors wrote, “This large and comprehensive analysis of a large data base from a multinational trial further adds to the observations that chronic HCV is associated with hepatic steatosis in approximately a fifth of patients.”

Further, they continued, “features of the metabolic syndrome are associated with hepatic steatosis in most of these patients. Steatosis is significantly more common in [patients with] genotype 3 compared with other genotypes, and in these patients, an SVR is associated with steatosis clearance.”

02/01/08